|
|
|
 |
| System for follow-up of tests and results 1.5.4 |
11-Aug-2005 |
|
|
|
By Christina Anastasopoulos.
THIS measure has been revised and now requires practices to have a system in place to recall patients with clinically significant tests and results. Practices are also required to have a written policy for the follow-up and recall of patients with clinically significant tests and results.
Similar measures were recommended, but not compulsory, in the previous standards. The second (previous) edition of the standards required practices to follow up and recall patients with “abnormal” results, but the new requirement has been changed to cover anything considered “clinically significant”.
The RACGP says this indicates that even negative results may need to be followed up with further tests and investigations.
Medicolegal experts say this is a key area of risk for practices and the focus should be on having a system in place that is acknowledged, understood and followed by all GPs and practice staff.
WHAT DO THE EXPERTS SAY?
The RACGP
The RACGP says determining what is “clinically significant” has been left up to GPs’ clinical judgment. But putting certain measures in place should ensure that patients with a potentially serious health outcome are properly followed up.
Suggested approaches:
- GPs place reminders in their e-mail calendar to alert them if a patient or result has not come back.
- GPs keep a “little black book” or exercise book of patients they must follow up.
- GPs ask staff to remind them to check that a particular patient or result has returned.
- Practice GPs and staff divide themselves into sub-teams (buddy-up) so that two or three GPs and staff are responsible for following through if a buddy is away.
The RACGP says some medical software packages allow GPs to flag patients, but this requires them to actively look up the patient. The RACGP has approached the medical software industry asking that it set up systems to provide automatic alerts.
The Medical Defence Association of Victoria
The Medical Defence Association of Victoria says there is no one infallible system of management. Whatever system is used will work best when all doctors and practice staff agree to use it, and all are clearly informed of what is required of them.
The method must also be reinforced and regular audits carried out to ensure its efficiency.
A follow-up system does not need to be complicated and an effective approach can be as simple as keeping a table.
See table below for an example
MDAV says a reasonable attempt must be made to contact the patient, but this must also be relevant to the patient’s individual circumstances. Alternative contact attempts may be required for patients where English is their second language or if, for example, the patient has poor eyesight.
In cases where patient follow-up is required (ie, abnormal result, further investigations, etc) it is suggested that at least two phone calls are made in an attempt to contact the patient, followed by a letter sent by registered post. All attempts must be documented.
MDAV says experience has shown that mismanagement of test results is most likely to occur after the report has reached the requesting doctor’s practice.
The method of ensuring efficient control may vary according to the volume
of investigations undertaken, and the number of doctors (including locums), nursing and office staff employed at the practice. All these factors can contribute to the incidence and risks of mismanagement.
MDA National
MDA National recommends that when attempting to contact patients, GPs call them three times - once in the morning, once in the afternoon and again the following day.
GPs should never leave detailed messages relating to the patient’s personal health on answering machines in case they are screened by another party.
All phone calls, including the date and time they were made, should be documented in the patient’s medical records.
If the three phone calls are unsuccessful, GPs should follow with a registered letter. This ensures that GPs have documented proof they have sent a letter. And because it is registered and there is minimal chance that a person other than the patient will read the information, the letter can be as detailed as the GP feels necessary.
GPs are not expected to do anything further after this point.
THE FINER POINTS
Who is responsible?
While administrative staff should be included in this process, the GP is ultimately responsible for the care of the patient and must be satisfied that follow-up systems within the practice are sound and efficient.
The RACGP says one of the most fundamental aspects of this measure is that there is a practice-wide approach to patient recall and follow-up.
Put it in writing
Practices should keep a succinct document that can be understood by all staff, outlining in a dot point format the methods they use for recall and follow-up, according to MDA National.
It should also include details on who is responsible for what tasks and set clear boundaries.
Further information
GPs are advised to seek further assistance and guidance from their medical defence organisation and the explanatory notes on pages 29-32 of the RACGP’s third edition practice standards document. Medicolegal opinion on the issue can be found on the RACGP’s web site at www.racgp.org.au
CASE STUDY: Camp Hill Medical Centre, Camp Hill, Queensland
he Camp Hill Medical Centre is not your typical surgery — it has 16 GPs and 17 support staff. It is also probably a bit of a revolutionary surgery in that it set up a recall and follow-up system about 15 years ago, well before it was considered a requirement for best practice.
But Ms Jan Chaffey, senior practice manager for the centre and national president of the Australian Association of Practice Managers, says the decision to implement this system was simple and based on GPs’ belief that it was integral to best practice for both patients and the surgery.
The centre uses IBA Plexus medical software to set up standard reminders for things such as regular Pap smears, colonoscopy checks, breast checks and immunisations. It is backed by a timetable that is checked weekly by an administrative staff member who is allocated the job of sending reminder letters to patients due for certain routine tests.
The system also includes a “make appointments” section that is checked daily by a registered nurse. This section includes patients who have important tests done and need to be followed up.
Ms Chaffey says the RN usually calls patients up to three times at different times of the day, followed by a standard letter, and finally a registered person-to-person letter if all else fails. These letters are initiated by the GPs, who include specific information on the need for follow-up.
However, she says if a patient needs urgent attention a registered letter is sent earlier than usual.
Asking for patients’ mobile phone numbers has also helped the practice reach patients sooner.
The practice also has a computerised internal messaging system, much like Microsoft Outlook, which allows GPs to send themselves personal reminders to check on a particular patient or result. This acts as a back-up and ensures that important tests are received by the practice and seen and acted on by the GPs.
Ms Chaffey says the system has not been expensive or overly time-consuming for the practice, but other practices can expect some expense in setting up a similar system.
Aside from the medical software, which Ms Chaffey says most practices should already have in place, the Camp Hill Medical Centre outlays around $200 a week on:
- RN to call patients with important follow-ups — one hour a day is usually spent calling an average of 10 patients. This equates to about $110 per week.
- Cost of phone calls to contact these patients — $12 a week.
- Paper and envelopes for reminder letters — about 80 reminder letters are sent out a week, costing $10 in stationery.
- Staff time to generate the letters — about $35 for two hours of staff time.
- Postage stamp to send the letters — about $40 a week.
- Registered person-to-person letters are sent out infrequently and are not considered a regular cost for the practice.
Ms Chaffey says the $200 a week spent on these areas usually generates an extra 130 appointments for the practice per week, so they also help generate income.
But more importantly, the cost is outweighed by the benefit of ensuring patients are receiving optimal service and care and the potential medicolegal costs should a patient have an adverse outcome in the event something is missed.
SOME OF THE MAIN CHANGES
- Removal of two-day appointment rule, which was included in the 2nd edition of the RACGP Standards for General Practices and the 3rd edition draft.
- Practices must now have a detailed recall and follow-up system for clinically significant tests and results.
- Removal of draft document’s requirement for complaints and significant events registers, but practices must now demonstrate how they identify and report a mistake, and how they prevent it from recurring.
- Removal of draft document’s requirement to have a defibrillator, special vaccine fridge and height-adjustable beds.
- Previous standard specifying that GPs must see less than six patients an hour removed, but the standard governing medical records now includes specific details about what information must be documented to ensure standard of care is not compromised if GPs see more patients than this.
- Practices need to demonstrate that they are working towards the recording of self-identified cultural background (eg, Aboriginal and Torres Strait Islander self-identification).
- At least 90% of active medical records must document patients’ allergy histories.
- At least 50% of active medical records must contain a health summary — up from 25%.
- New information technology security measures require practices to have an information disaster recovery plan.
- Practices are no longer required to use patient surveys for feedback, but must demonstrate how patient feedback is sought and acted on.
- New human resources measures introduced, including an induction program for new staff.
- Practices must hold regular clinical meetings to discuss how to tackle health problems and ensure there is clinical consistency within the practice.
- Practices must demonstrate improvements they have made in the last three years.
CLINICAL MEETINGS 1.5.3 (b)
This is now a flagged item and requires practices to have regular clinical meetings.
Any staff member can attend, but the topic of discussion should relate to clinical issues, such as individual clinical cases; how to deal with specific conditions, such as diabetes management; or how to ensure that GPs and other staff are being clinically consistent across the practice.
Quality Practice Accreditation says GPs and staff can also review clinical guidelines in these meetings and agree on parameters of care for their practice.
The RACGP says the meetings can take place as often as practices feel is necessary, but need to be regular. Most often the topic will be the practice’s approach, rather than individual patients. If individual patients are discussed, informed consent (not necessarily written) must be obtained and documented in their notes.
Meetings do not need to take place at the surgery; meeting at a cafe over lunch, for example, is acceptable, provided the topic of discussion is directly related to clinical issues and the focus is on improving consistency and quality of care.
Australian General Practice Accreditation Ltd says it is not necessary to document the meetings through minuting, or to develop a policy to put in the Policy and Procedure Manual, but this would be a good idea.
Accreditation surveyors will determine if the meetings have taken place by observing blocked times in the appointment schedule and interviewing GPs and staff.
IT SECURITY REQUIREMENTS 4.2.2
THE standards do not force practices to move to a computerised system — paper-based systems are still allowed. However, practices that use computers to store patient health information must:
- Use personal passwords to authorise appropriate levels of access to health information.
- Have screensavers that are used for automated privacy protection.
- Ensure frequent backup of electronic information is done and this is stored in a secure off-site location.
- Ensure antivirus
software is installed and updated on a regular basis.
- Ensure hardware/software firewalls are installed to all computers connected to the Internet.
This criterion also requires computerised practices to have a disaster recovery plan that has been developed and tested and is documented.
Neil McAliece, information management and technology manager at Murrumbidgee Division of General Practice, says most practice systems should not need upgrading, provided they are already at a satisfactory level to run current practice software.
He says systems requirements will vary depending on what software practices are running, but as a general guide computers should be reviewed if they are older than three years, have a workstation memory of less than 512K, or a server memory of less than 1Gb.
PASSWORDS
Each PC should require a password to access it. This does not need to be a separate password for each staff member, because several people will often share a PC during the day.
However, Mr McAliece says everybody needs their own login name and password for things such as clinical and billing software, and in the doctors’ cases, this should be confidential to ensure the audit trail of practice clinical and financial systems cannot be compromised.
If a non-GP makes an entry into a patient file under a doctor’s name, then it can only be attributed to that doctor and will carry the same professional weight as a genuine doctor’s entry when reviewed by others later. This could create problems in a medicolegal situation.
If doctors or staff stop using a computer, they should log off from the clinical/billing software.
SCREENSAVERS
These act as a privacy protection device and only require simple configuration. Having a screensaver that activates after a few minutes can stop people from reading important or private information from an unattended PC.
The screensaver can also be set up so it requires a password to be deactivated.
BACKING UP
Mr McAliece says this is often carried out incorrectly in general practices and GPs should get professional input into backing-up data.
Things to consider:
- Frequency of backup.
- Type of storage media.
- Setting up a procedure so a non-technical person can do some basic checks to determine if the backup ran or not.
- Special requirements for database backups.
- Document and e-mail backup.
- Centralising storage to a server and stopping staff from saving data on their local hard drives.
- Have a log sheet that is signed off by those responsible for changing media and checking backups.
- Who is responsible for taking backups off-site and how are they stored (eg, principal GP or practice manager taking them home and securing them in a locked, fire-retardant box).
VIRUS PROTECTION
Antivirus software is required only for computers using Windows, not for Apple OSX or Linux machines. Antivirus software must be installed on every Windows PC in the practice. Legally you need a licence for each PC the software is installed on. Mr McAliece says practices should not buy off-the-shelf software intended for one PC and install it on 10 PCs; you can get better pricing by buying licence packs. For example, eTrust’s VET antivirus has a 10-client licence pack for 10 machines.
Mr McAliece says each machine should be configured so that the antivirus software checks for updates a few times a day and applies the updates without user interaction (in the background). Periodically (each month or so) someone should check that the automatic updates have worked.
Cost: $500-$600 for 10 PCs.
FIREWALLS
A firewall is software or hardware that controls network traffic based on a set of rules. You could have a single firewall device at or before your Internet gateway device (eg, ADSL modem router). All traffic entering or leaving the practice will have to pass through this device and be accepted or rejected based on the rules set in the device.
Alternatively, practices could have a software firewall in each PC that does the same job. You could also have a software firewall in each PC and a hardware firewall at your Internet gateway. If you have upgraded Windows XP to Service Pack 2, then you will already have a software firewall included.
Mr McAliece recommends practices install a hardware device that all traffic must flow through on the way into and out of the practice.
What do firewalls protect?
Firewalls are not a “magic security fix”; just having one does not mean your data is protected. Firewalls do not inspect content. If someone e-mails out a file that contains a list of all patients and their current medications, the firewall will not stop that. The firewall will only recognise an attempt to connect to the mail server and allow it through.
A poorly configured firewall can be as bad as no firewall at all. Even a professionally configured firewall is not an absolute guarantee of data security.
What will a firewall cost?
A separate hardware firewall might be $800. However, many ADSL modems now include a good hardware firewall, which will cost $150-$400.
How do I set up a firewall?
The most secure way to set up a hardware firewall is to start with a rule that blocks all traffic, and then only open up protocols and ports that you know you will need, such as the web, mail and communication software for retrieving diagnostic results. This will need to be done by an experienced professional.
The problem with doing this, though, is that if you add new software to your system, you may have to adjust the firewall to allow through traffic needed for this new software.
An example of this might be if you change pathology labs and they use different messaging software to your old provider.
You also need to be cautious when adding software firewalls to individual machines.
For example, if your practice database server runs Windows XP and you upgrade to Service Pack 2, which includes a firewall, you may find that programs like Pracsoft or Medtech32 no longer operate because their access to the database server has been blocked by the firewall.
The fix requires putting an exception into the firewall for internal machines for the network port number that your database server uses.
DISASTER RECOVERY PLAN
Mr McAliece says this can simply be a list of scenarios you have considered and how you would deal with them. For example, a server and/or workstation crash, loss of the server through theft or fire, or power loss.
A response to these events might be something like:
1. Be aware of where manual receipt/account books and Medicare forms are kept.
2. Operate manually in the short term.
3. Have the latest backups on hand (retrieve off-site backups if necessary).
4. Contact an IT contractor to discuss options (eg, short-term hire of a server while a replacement is ordered, and restore data or temporarily configure a workstation to act as a server).
Core parts of testing disaster recovery
1. Ensure the necessary items can be found quickly to operate manually.
2. Test restored backup data and make sure the result is usable.
Mr McAliece says unless the practice has someone on staff who is proficient with information systems, it is critical the practice gets professional help with a test restore of backup data. Done incorrectly, a practice could mistakenly destroy good data.
HUMAN RESOURCE MANAGEMENT PROCESS 4.1.1
This is a new section that requires:
- Practices to have an induction program for new GPs and staff.
- GPs and staff to describe their roles within the practice.
- The practice to identify the people responsible for co-ordinating patient feedback and the investigation and resolution of complaints.
There is also an unflagged recommendation that GPs and staff have position statements.
INDUCTION PROGRAM
The RACGP says an induction program for new staff is important to ensure GPs are aware of things such as practice processes, local referral networks, occupational health and safety issues, and key public health regulations.
This is particularly important for GPs who move areas or states. The induction program should include both a face-to-face meeting and a written policy for future reference.
STAFF ROLES
The RACGP says it is important for all GPs and staff to know their role within a practice. In the case of reception staff, it should be clear who is responsible for purchasing items, security issues, and various administrative duties, while in the case of GPs it needs to be clear if any are particularly familiar with clinical areas, for example, HIV management, paediatrics or minor surgery.
IDENTIFYING THE PERSON RESPONSIBLE FOR LEADING CLINICAL IMPROVEMENT
The practice should be able to identify who is responsible for co-ordinating and checking on clinical improvement issues, such as auditing the recording of allergies in health summaries, or checking the immunisation status of the practice.
The RACGP says by allocating responsibility to an individual(s), there is less chance that these activities will be forgotten or delayed.
Job describtions (unflagged)
The RACGP says although this is not a requirement of the standards, it is a good measure for practices to work towards so there is no confusion about staff expectations.
A document that clearly states the job requirements of GPs and practice staff helps everybody understand what is expected of them.
Need more guidance?
Further information and guidance on GP-specific human resource issues can be obtained from the Australian Association of Practice Managers’ publication The Guide: AAPM business manual for health care (www.aapm.org.au); the AMA; and the RACGP’s Employment Kit: Tips in negotiating an employment contract in general prac
tice.
Quality Practice Accreditation also has modules to help practices in these areas.
PATIENT HEALTH RECORDS (ABORIGINAL DOCUMENTATION) 1.7.1(d)
This is a new flagged item requiring practices to demonstrate they are working towards recording in their medical records the cultural background of patients, particularly those from an Indigenous background.
The RACGP says this is an important question in history-taking to help identify sub-groups of patients that may need better-targeted health care.
What can practices do?
Australian General Practice Accreditation Ltd says practices with computer-based medical record systems could incorporate a prompt or reminder to ask the question, while paper-based practices could add a new section to their paper records. Practices could also place posters in the waiting room or information in their newsletters asking patients to inform their GP of their cultural background, or include an extra question on the patient information forms new patients to fill out.
This indicator is supported by an unflagged recommendation in 1.4.1(e) for practices to work towards accessing guidelines for specific clinical care of patients who self-identify as Aboriginal or Torres Strait Islander.
The standards document includes examples of resources GPs can use to obtain this information, such as the Internet, the RACGP library and the National Aboriginal Community Controlled Health Organisation (NACCHO).
The RACGP says it could also be as simple as knowing someone in Aboriginal health who can point practices in the right direction.
This is not a new section, but a previous requirement to have patient suggestion boxes has been removed. Practices can now choose a process to collect and respond to patient feedback.
AGPAL has developed a CD entitled The People We Treat in conjunction with the Australian Council for Safety and Quality in Health Care to discuss sourcing patient feedback and implementing it in the practice.
The CD suggests that GPs consider using de-identified patient feedback surveys, focus groups and/or a complaints register.
QPA also has a patient feedback system, which involves three surveys, including guidelines for conducting a patient feedback group.
The Consumers’ Health Forum of Australia says patients do not tend to favour written surveys because they do not feel these give them enough scope to say what they want.
Research conducted by the forum in 1998 found patients preferred short phone interviews and group discussions. The forum has a consumer feedback package — available free of charge to GPs via its web site www.chf.org.au — outlining alternative avenues for practices to consider.
The RACGP says some practices hold focus groups for certain categories of patients, such as new mothers, to better understand their needs and extra requirements.
It recommends that practices refer to the Council for Safety and Quality’s advice document — available online at www.safetyandquality.org/articles/Publications/10tipsumclnbx.pdf — for further guidelines on dealing with patient feedback and complaints.
Criterion 2.1.2 also includes a new recommendation, not requirement, for practices to describe an improvement they have made in response to patient feedback or complaints.
The RACGP says this indicates a move away from how the feedback is sought to how the practice makes appropriate changes in response.
PATIENT FEEDBACK 2.1.2
This is not a new section, but a previous requirement to have patient suggestion boxes has been removed. Practices can now choose a process to collect and respond to patient feedback.
AGPAL has developed a CD entitled The People We Treat in conjunction with the Australian Council for Safety and Quality in Health Care to discuss sourcing patient feedback and implementing it in the practice.
The CD suggests that GPs consider using de-identified patient feedback surveys, focus groups and/or a complaints register.
QPA also has a patient feedback system, which involves three surveys, including guidelines for conducting a patient feedback group.
The Consumers’ Health Forum of Australia says patients do not tend to favour written surveys because they do not feel these give them enough scope to say what they want.
Research conducted by the forum in 1998 found patients preferred short phone interviews and group discussions. The forum has a consumer feedback package — available free of charge to GPs via its web site www.chf.org.au — outlining alternative avenues for practices to consider.
The RACGP says some practices hold focus groups for certain categories of patients, such as new mothers, to better understand their needs and extra requirements.
It recommends that practices refer to the Council for Safety and Quality’s advice document — available online at www.safetyandquality.org/articles/Publications/10tipsumclnbx.pdf — for further guidelines on dealing with patient feedback and complaints.
Criterion 2.1.2 also includes a new recommendation, not requirement, for practices to describe an improvement they have made in response to patient feedback or complaints.
The RACGP says this indicates a move away from how the feedback is sought to how the practice makes appropriate changes in response.
CASE STUDY: Keperra Family Practice, Queensland
Most practices use patient surveys and suggestion boxes for patient feedback and then do little, if anything, with the information.
But the Keperra Family Practice encourages patients to provide feedback via a suggestion box and direct communication with their GP and reception staff, which in turn is input into a computerised human resource software program that helps the practice track potential problems.
The program, called Performance Plus, is marketed as a human resource tool to help businesses assess staff performance and encourage staff motivation.
However, Dr Trish Baker says her practice soon realised the program could also be used to document patient feedback and determine if a pattern was emerging.
This has helped the practice identify key areas in need of change, such as long waiting times.
“We found a useful adaptation for it [the program],” Dr Baker says. “It’s important to know where you’re going wrong and to try to fix things where you can.”
The practice now books longer appointments for patients with more complicated health needs, and GPs try to prioritise investigations during a consultation so that one presenting problem does not evolve into lots that require too much time.
Dr Baker says there is no point having a suggestion box or patient survey if the practice does not respond to the comments received.
She says a patient-centred practice should try to use that information, no matter how it is received, to make improvements.
HEALTH SUMMARIES 1.7.2
This criterion has changed and now requires practices to ensure that at least 90% of active health records contain a record of allergies.
The RACGP says this is an important issue in the context of computer-assisted prescribing. It can be done by including a question in the patient information forms for all new patients or reminding patients via the practice newsletter to ensure they disclose any allergies at their next consultation.
The RACGP says practices can easily track if they meet the new quota by auditing a day’s or week’s medical records to reach an average. This criterion also requires practices to ensure that at least 50% of active health records contain a health summary. This has increased from 25% in the previous standards.
The RACGP also clearly lists what information must be included in these summaries, including:
- Adverse medicines events.
- Current medications.
- Current health problems.
- Past health history.
- Risk factors.
- Immunisations.
- Relevant family history.
- Relevant social history.
The RACGP says these are areas considered critical to a patient’s health management, which will also allow any other GP in the practice to understand and take over the care of a patient if required.
This is particularly important in large medical centres where patients see multiple GPs.
PRACTICE IMPROVEMENTS 3.1.1
This is a new flagged item requiring GPs and staff to describe an aspect of the practice they have improved in the past three years.
AGPAL says any element of the practice can be improved, ranging from as little as putting plants in the waiting room, to improving staff satisfaction through incentives.
The RACGP says it is not necessarily interested in the scale of the improvement as much as the practice identifying and acting on an issue they feel is important.
AGPAL recommends that GPs use the PDSA (Plan, Do, Study, Act) cycle for continuous quality improvement, which encourages practices to test ideas before large-scale changes are implemented.
It provides an opportunity to review the effects of the testing process and try out change on a small scale before implementing large-scale changes.
How to use the PDSA model
PLAN: What is it that you are trying to accomplish? What is the overall aim of what you are doing or trying to achieve?
DO: Test out the ideas. The planning phase should make it easy to get started.
STUDY: Reflect on what has happened and build knowledge for further improvement.
ACT: A decision is made on the way to move forward. More evidence may need to be gathered before change can be implemented.
CASE STUDY: Benalla Church Street Surgery, Victoria
Fed up with dealing with aggressive patients, the GPs and staff at Benalla Church Street Surgery decided it was time for a zero tolerance stance and implemented an ‘Acceptable behaviour policy’.
Mrs Meryl Jerome says the practice experienced inappropriate behaviour from some patients who would swear and scream if they did not get what they want, or refuse to pay their bills and argue with front-desk staff. This led to increased levels of staff stress, so a decision was made to take action.
All 10 GPs and 13 administrative staff met to write up a policy of what behaviour would and would not be acceptable, and how the practice should deal with aggressive patients.
The policy outlines a procedure that staff should follow: remove the loud and aggressive patient from the front area into another room, avoid confrontation, and send the patient a letter informing them that the practice will not tolerate such behaviour and if it recurs the patient may be refused to be seen.
“This way the staff feel supported and patients know we’re not prepared to put up with that behaviour,” Mrs Jerome says.
Mrs Jerome says the policy has improved staff morale and confidence, and provided the practice with a clear plan in the case of such a scenario.
CLINICAL RISK MANAGEMENT SYSTEM 3.1.2
The draft version of the latest standards had a controversial recommendation for practices to keep a complaints register. This has been removed from the final version. GPs were concerned that their efforts to improve care would not attract ‘qualified priviledge’, as such efforts often do in other settings. The potential accessibility of the information in the register was confirmed in the legal advice to the RACGP. It has been replaced with a compulsory requirement for GPs and practice staff to describe the process for identifying and reporting a slip, lapse or mistake in clinical care. There is also an unflagged recommendation that GPs and practice staff describe an improvement they have made to prevent these from recurring. This reflects the importance of acting on, rather than ignoring, risks to patients that are identified within the practice.
What should practices do?
The RACGP says this measure is about encouraging a practice culture where it is okay to tell somebody about a potential or suspected problem, rather than ignore it and say nothing.
It says mistakes and problems do not need to be big or life-threatening in order to be reported. Practices also do not need to document mistakes if there is no adverse effect and the mistake can be fixed within the practice.
Practices simply need to have a process in place where GPs and staff know where and to whom to report slips, lapses and mistakes so they are not missed.
|
|
|
| | Related Articles - Practice management - Standards | |
|
|
|
|
Subscribe to our daily newsletter
|
|
|
|
|
|
| |
|
|
| |
|
Submit your feedback here: